Radiotherapy for chronic lymphocytic leukaemia (CLL)

Radiotherapy uses high energy waves similar to x-rays to kill cancer cells. You don’t often have radiotherapy for chronic lymphocytic leukaemia (CLL).

Your doctor might suggest it if your spleen Open a glossary item or lymph nodes Open a glossary item are very swollen (enlarged) or causing you symptoms.

Why do you have radiotherapy for CLL?

You might have radiotherapy if other treatments are no longer working very well.  Your doctor might suggest you have radiotherapy to help with the following problems:

Enlarged spleen

The spleen is an organ on the upper left side of your tummy (abdomen). In CLL, it sometimes becomes bigger (enlarged).

An enlarged spleen can cause pain or make you uncomfortable. Your specialist might suggest surgery to remove your spleen to help these symptoms. If there is a reason why you can't have surgery, you might have radiotherapy. The aim is to shrink your spleen and reduce symptoms.

You usually have treatment 3 times a week. This works well for most people.  If your spleen gets bigger again you might be able to have more radiotherapy.

Bulky lymph nodes

One of the symptoms of CLL is swollen lymph nodes. Your doctor might suggest radiotherapy to help to shrink the lymph nodes.

There are different ways of having radiotherapy to swollen lymph nodes. You might have daily treatment for 2 weeks or less. Or you might have your radiotherapy 1 to 3 times a week.

Bone pain

Some people with CLL have bone pain. This can happen because there are too many leukaemia cells in the bone marrow. This puts pressure on nerves and causes pain.

You can have radiotherapy for bone pain.

Before treatment

You have a planning session which lasts around 90 minutes.

The radiotherapy room

Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine might be fixed in one position or able to rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.

Before your first treatment, your therapy radiographers Open a glossary item will explain what you will see and hear. In some departments the treatment rooms have docks for you to plug in music players. So you can listen to your own music while you have treatment.

Photo of a linear accelerator

During the treatment

You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.

Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.

You won't be radioactive

This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.

Travelling to radiotherapy appointments

You might have to travel a long way each day for your radiotherapy. This depends on where your nearest cancer centre is. This can make you very tired, especially if you have side effects from the treatment.

You can ask the therapy radiographers Open a glossary item for an appointment time to suit you. They will do their best, but some departments might be very busy. Some radiotherapy departments are open from 7am till 9pm.

Car parking can be difficult at hospitals. Ask the radiotherapy staff if you are able to get free parking or discounted parking. They may be able to give you tips on free places to park nearby.

The radiotherapy staff may be able to arrange transport if you have no other way to get to the hospital. Your radiotherapy doctor would have to agree. This is because it is only for people that would struggle using public transport and have no access to a car. 

Some people are able to claim back a refund for healthcare travel costs. This is based on the type of appointment and whether you claim certain benefits. Ask the radiotherapy staff for more information about this.

Some hospitals have their own drivers and local charities might offer hospital transport. So do ask if any help is available in your area.

Side effects of radiotherapy

Radiotherapy can cause:

  • a skin reaction, like sunburn, in the treatment area
  • tiredness 

These might be the only side effects you have. The side effects may be mild, depending on how much treatment you have.

Other possible side effects depend on the area of the body having the radiotherapy. Side effects of radiotherapy to your spleen might include:

  • feeling sick, as well as tired
  • a drop in your blood cell counts

Side effects are not usually severe. This is because you have a low dose of radiation and a short course of treatment.

Last reviewed: 
24 Sep 2021
Next review due: 
24 Sep 2024
  • Advances in radiotherapy

    S Ahmed and others

    British Medical Journal, 2012. Volume 345

  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser 
    Wiley-Blackwell, 2015

  • Radiotherapy Services in England 2012

    Department of Health, November 2012

  • National Radiotherapy Implementation Group Report Image Guided Radiotherapy (IGRT). Guidance for Implementation and Use

    NHS National Cancer Action Team, August 2012

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